One of the hallmarks of being a teen is breaking out in acne, but a Toronto dermatologist says that kids might not wait until they are teenagers to see their first pimples.

Dr. Paul Cohen, a dermatologist at Toronto’s Rosedale Dermatology Centre, says that puberty is happening at an earlier age and, as a result, cases of early acne have become the new normal.

"I've been noticing kids coming into my office that are seven or eight or nine with pimples," Cohen told Canada AM. "Normally they come in with warts or impetigo (blisters cause by bacteria), and now I have kids coming in with acne. And of course their parents are very concerned."

Cohen says there are a couple of theories as to why puberty is happening at a younger age, including obesity and environmental triggers.

Children that are obese are more likely to go through puberty earlier because fat can synthesize estrogen – the hormone that plays a key role in puberty for young girls.

"A lot of environmental causes can lead to puberty occurring at an earlier age," Cohen said, also pointing to chemicals in plastics and flame retardants as possible culprits.

Cohen says it is important for parents to help their pre-teens practice a healthy skin routine that includes washing your face twice a day, using non-oily sunscreens and applying moisturizers if the skin gets too dry from pimple medication.

Some children Cohen treats are very self-conscious of their pimples because, at such an early age, they may be the only one in their class with pimples.

But his message to parents? "Don't get overly concerned and don't make your child overly conscious about the acne on their face. Just help get in good skin behaviour."

Parents must also be patient as results from over-the-counter treatments, like benzoyl peroxide creams, could take up to three months to show any results.

Cohen says birth control can help control acne and adds that he is now suggesting girls as young as 13 or 14 go on the pill.

Unfortunately, acne at an early age also means the potential for even worse acne during adolescent years.

"So you want to treat it early, get them into the habit of taking good care of their skin at a young age so that they really can prevent future bad acne," Cohen said.

Cohen also stresses to parents that they can expect early acne to be the new “normal.”

"We know now that a lot of normal kids will develop acne at this young age," he says.